Health security
DEMAND AND SUPPLY - Boo Chanco (The Philippine Star) - February 3, 2020 - 12:00am

It is often said that modern medicine has made it possible for humans to live well beyond their 90s. Modern medicine seems to have a solution for most of our common medical problems or at the verge of having one. Even cancer, a most dreaded disease, need not be a death sentence anymore.

I heard someone say that if we can only survive the next 10 to 20 years, medical science would have progressed enough to make living up to a hundred nothing unusual. Work on genetics and stem cells with the assistance of supercomputers promises to deliver made-to-order cures we can only dream of today.

But there is one area of medical science that is still playing catch up --- dealing with infectious bacteria and viruses with the potential of unleashing pandemics with the horror experienced in the past. Here, preventive medicine is key.

My late father, an expert in public health and preventive medicine in our tropical context, used to complain about how his area of interest isn’t getting the kind of attention and research grants other specializations get. When he retired, there was no one to pass on the baton to.

Dealing with germs, parasites and viruses isn’t sexy, my dad used to complain. No one is interested enough in tropical medicine except when epidemics erupt and health officials scramble for quick solutions.

We are a tropical country but there was little interest in tropical medicine until the Japanese funded the establishment of the Research Institute of Tropical Medicine (RITM) in the early 80s. By that time, we already had state of the art facilities to handle heart, kidney and lung diseases.

RITM still gets less attention and less funding today. The lack of attention frustrated my dad until the Army called for him because they were losing more soldiers to malaria in Mindanao than to the bullets of Misuari’s MNLF. They needed someone who understands malaria.

Today, RITM is responsible for, among other things, handling highly infectious diseases like the various strains of coronaviruses. It handles the isolation wards for these deadly diseases. I think it deserves the respect and funding of a heart center… and the interest of the best and the brightest among our young doctors.

The attention that this Wuhan coronavirus is getting should also spur more long-term interest in the work being done by RITM. My friend Rep Joey Salceda is proposing the creation of our version of America’s Center for Disease Control. That’s well and good but…

I wonder if we need another agency when we already have RITM. Maybe expand RITM’s area of responsibility but more importantly, proper funding must be given. Congressmen love to create new agencies but after the press releases are published, they forget to provide adequate funding.

Assuming Joey’s CDC is created, it cannot be a copy of the American CDC simply because we have different needs as a tropical country. Simply put, RITM already covers those needs although admittedly, they can use more funding to better carry out their mandate.

Indeed, one of the first things that must be done is to attract more top talents in medicine to get interested in tropical diseases. In my father’s time, there are more fingers in one hand than experts in tropical medicine in this country.

It is understandable that the top medical graduates want to be cardiologists or surgeons or oncologists. Lately, dermatology is the field to go to make as much money as quickly as possible.

Tropical medicine, on the other hand, deals with unspeakable things from stinky bloody mucoid stools, eeky parasites, pesky insects and generally poor patients so the doctor is even out of pocket in providing medicines.

Then again, the coronaviruses have leveled the field somewhat so that the upper class is now as vulnerable to today’s pandemics, if not more so because of high speed travel. So maybe, just maybe, an institution like RITM will get attention and respect.

The World Economic Forum observed that we are now in “a new era in the risk of epidemics… The number and diversity of epidemic events has been increasing over the past 30 years, a trend that is expected to intensify.”

The WEF warns that “the world is poorly prepared for even modest biological threats. We are vulnerable to potentially huge impacts on individual lives, societal well-being, economic activity and national security.”

 There is also the additional threat of researchers in biotechnologies working on microorganisms for cures and also for biological warfare. Microbes or viruses escaping from laboratories increase the biological risks we face.

In sum, the world is now more vulnerable to societal and economic impacts from infectious-disease outbreaks, the WEF points out.

“One estimate of potential pandemics for the 21st century puts the annualized economic costs at $60 billion; this includes the imputed value of life-years lost. Another estimate puts the cost of pandemic influenza alone at $570 billion per year, which places it in the same order of magnitude as climate change.”

Outbreaks of infectious disease may be inevitable, but understanding these risks will enable us to reduce our exposure, improve our resilience and strengthen global health security.

In our local political context, it is important for our decision makers to realize that we cannot forever be just reacting every time a new virus or health threat emerges. Our experience over the last few weeks show how ill prepared our health officials are in responding to a biological threat.

We have no protocol to address the threat to public health and also calm the citizenry. We saw the spectacle of a Health Secretary more worried about how China will react to a move many countries were already taking to protect the health of their citizens.

The next epidemic of unknown virus may be more worrisome than the current one. Our health security demands more competence from our health officials.

Long term… invest in a world class center for tropical medicine. This is what our tropical country needs to survive the superbugs of the future.

Boo Chanco’s e-mail address is Follow him on Twitter @boochanco


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